Gluteal, Thigh, & Popliteal Fossa Flashcards
Explain organization of fascia lata
Extension of inguinal ligament
Inferiorly continuous with fascia of leg inferior to knee
Thickened by additional longitudinal fibers to for iliotibial tract
Explain Iliotibial tract
shared aponeurosis of the tensor fascia latae and gluteus maximus muscles
Extends from iliac tubercle to anterolateral tubercle of the tibia
Anterior compartment of thigh contents
Tensor fasciae latae
Iliopsoas
Sartorius
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
Articularis genu
Femoral n. a. and v.
Anterior compartment of thigh actions
Flex hip
Extend knee
Anterior compartment of thigh innervation
Femoral n. (Except tensor fasciae latae > superior gluteal n.)
Anterior compartment of thigh blood supply
Femoral a.
Medial compartment of thigh contents
Adductor longus
Adductor magnus
Gracilis
Adductor brevis
Obturator externus
Pectineus
Obturator n. and a.,
Medial compartment of thigh actions
Adduct thigh
Laterally rotate thigh
Medial compartment of thigh innervation
Obturator n. (adductor magnus hamstring part by sciatic n.)
Medial compartment of thigh blood supply
Obturator a.
Posterior compartment of thigh contents
Semimembranosus
Semitendinosus
Biceps femoris
Sciatic n.
Common fibular n.
Tibial n.
Posterior compartment of thigh actions
Extend thigh
Flex leg
Posterior compartment of thigh innervation
Tibial div. of sciatic n.
Posterior compartment of thigh blood supply
Sciatic a.
Iliacus attachments
from… iliac fossa, iliac crest, sacral ala & sacroiliac ligaments
to… lesser trochanter of femur
Iliacus actions
flexes and stabilizes the hip joint
Iliacus innervation
femoral nerve L2-3-4
Psoas major attachments
from… anterior transverse processes, vertebral bodies & discs (T12- L5)
to… the lesser trochanter of femur
Psoas major actions
flexes and stabilizes the hip joint
Psoas major innervation
ventral rami L1-4 (from lumbar plexus)
Rectus femoris attachments
from… anterior inferior iliac spine and groove superior to the acetabulum
to… the base of the patella
Rectus femoris actions
flexes hip
extends knee
Rectus femoris innervation
femoral nerve L2-3-4
Sartorius attachments
from… anterior superior iliac spine
to… the medial aspect of the proximal tibia
Sartorius actions
flexes hip
abducts hip
laterally rotates hip
flexes knee
assists in medial rotation of the knee
Sartorius innervation
femoral nerve L2-3
Tensor fasciae latae attachments
from… anterior superior iliac spine & external lip iliac crest
to… iliotibial tract
Tensor fasciae latae actions
Abducts hip
flexes hip
medially rotates hip
assists in maintaining knee extension
Tensor fasciae latae innervation
superior gluteal nerve L4-5-S1
Vastus intermedius attachments
from… the anterior aspect of the proximal 2/3rds of the femoral shaft
to… the lateral border of the patella
Vastus intermedius actions
Extends knee
Vastus intermedius innervation
femoral nerve L2-3-4
Vastus lateralis attachments
from… the intertrochanteric line, greater trochanter, gluteal tuberosity & linea aspera
to… the base & lateral border of the patella
Vastus lateralis actions
Extends knee
Vastus lateralis innervation
femoral nerve L2-3-4
Vastus medialis attachments
from… the intertrochanteric line, spiral line, linea aspera & medial supracondylar line
to… the base & medial border of the patella
Vastus medialis actions
Extends leg
Vastus medialis innervation
femoral nerve L2-3-4
Articularis genu attachments
from… the distal anterior shaft of femur
to… proximal portion of synovial membrane of knee joint
Articularis genu actions
pulls articular capsule proximally
Articularis genu innervation
femoral nerve (a branch of the nerve from the vastus intermedius) L2-3-4
Adductor brevis attachments
from… inferior pubic ramus
to… distal 2/3 pectineal line and medial lip linea aspera
Adductor brevis actions
Adducts hip
Flexes hip
Adductor brevis innervation
obturator nerve L2-3-4
Adductor longus attachments
from… pubic crest
to… medial lip linea aspera
Adductor longus actions
Adducts hip
Medially rotates hip
Flexes hip
Adductor longus innervation
obturator nerve L2-3-4
Adductor magnus attachments
from… the inferior pubic ramus, ischial ramus & tuberosity
to… gluteal tuberosity, linea aspera (adductor part), medial supracondylar ridge & adductor tubercle of the femur (hamstring part)
Adductor magnus actions
Adducts hip
(adductor part) flexes hip
(hamstring part) extends hip
Adductor magnus innervation
adductor part (obturator n. L2-3-4), hamstring part (tibial division of the sciatic nerve L4-5-S1)
Gracilis attachments
from… the body of the pubis & inferior pubic ramus
to… the medial surface of tibia, distal to condyle, proximal to insertion of semitendinosus, lateral to insertion of sartorius
Gracilis actions
Flexes knee
Medially rotates knee
Adducts hip
Gracilis innervation
obturator nerve L2-3-4
Pectineus attachments
from… superior pubic ramus
to… the femur between the lesser trochanter & linea aspera (pectineal line)
Pectineus actions
Adducts hip
Flexes hip
Pectineus innervation
femoral nerve & obturator nerve L2-3-4
Obturator externus attachments
from… rami of the pubis and ischium; external surface obturator membrane
to… trochanteric fossa
Obturator externus actions
Laterally rotates the hip
Obturator externus innervation
obturator nerve L3-4
Superior gemellus attachments
external surface spine of ischium via obturator internus tendon
to… greater trochanter
Superior gemellus actions
Laterally rotates hip
Superior gemellus innervation
sacral plexus L5-S1-2
Inferior gemellus attachments
proximal ischial tuberosity via obturator internus tendon
to… greater trochanter
Inferior gemellus actions
Laterally rotates hip
Inferior gemellus innervation
sacral plexus L4-5-S1
Gluteus maximus attachments
from… the aponeurosis of the erector spinae, sacrum, sacrotuberous ligament & posterior gluteal line (innominate)
to… the greater trochanter, gluteal tuberosity of the femur & the iliotibial tract
Gluteus maximus actions
Extends hip
Laterally rotates hip
Gluteus maximus innervation
inferior gluteal nerve L5-S1-2
Gluteus medius attachments
from… the external iliac surface
to… the oblique ridge on the lateral aspect of the greater trochanter; gluteal aponeurosis
Gluteus medius actions
Abducts hip
Medially rotates hip
Keeps pelvis level when opposite leg is raised
Gluteus medius innervation
superior gluteal nerve L4-5-S1
Gluteus minimis attachments
from… the external iliac surface and margin of the greater sciatic notch
to… the anterolateral aspect of the greater trochanter
Gluteus minimis actions
Abducts hip
Medially rotates hip
Keeps pelvis level when opposite leg is raised
Gluteus minimis innervation
superior gluteal nerve L4-5-S1
Obturator internus attachments
from… the anterolateral wall of the pelvis & obturator membrane
to… the medial surface of the greater trochanter
Obturator internus actions
Laterally rotates hip
Obturator internus innervation
nerve to the obturator internus L5-S1-2
Piriformis attachments
from… the anterolateral sacrum & posterior inferior iliac spine
to… the upper border of the greater trochanter
Piriformis actions
Abducts hip
Laterally rotates hip
Piriformis innervation
nerve to piriformis S1-2
Quadratus femoris attachments
from… the ischial tuberosity
to… the quadrate tubercle of the femur
Quadratus femoris actions
Laterally rotates the hip
Quadratus femoris innervation
nerve to the quadratus femoris L4-5-S1
Biceps femoris attachments
from… the ischial tuberosity & sacrotuberous lig. (long head); lateral lip of linea aspera & lateral supracondylar line (short head)
to… the lateral side of fibular head
Biceps femoris actions
Flexes knee
Laterally rotates knee
(long head only) Extends hip
Biceps femoris innervation
tibial division of sciatic L5-S1-2-3 (long head) & fibular division of the sciatic nerve L5-S1-2 (short head)
Semimembranosus attachments
from… ischial tuberosity
to… posterior aspect of the medial tibial condyle
Semimembranosus actions
Extends hip
Flexes knee
Medially rotates knee
Semimembranosus innervation
tibial division of the sciatic nerve L4-5-S1-2
Semitendinosus attachments
from… the ischial tuberosity
to… the proximal, medial tibia
Semitendinosus actions
Extends hip
Flexes knee
Medially rotates knee
Semitendinosus innervation
tibial division of the sciatic nerve L4-5-S1-2
Femoral triangle borders
Inguinal lig. (superior), adductor longus (medial), Sartorius (lateral), iliopsoas and pectineus (floor)
Femoral triangle contents
Femoral n. a. v.
Contents of greater sciatic foramen
Piriformis
Sciatic n.
Posterior femoral cutaneous n.
Superior gluteal vessels / n.
Inferior gluteal vessels / n.
Internal pudendal vessels
Pudendal n.
Contents of lesser sciatic foramen
Obturator internus
Internal pudendal vessels
Pudendal n.
Trendelenburg gait structure impairment
Pelvis tilts away from affected side.
Could be caused by disc herniation affecting superior gluteal n. (L4, 5, S1)
which affects gluteus medius and minimus from abducting
Draw Sacral Plexus
Quadratus lumborum n. axon function
sensory
postganglionic sympathetic
& motor innervation of the quadratus lumborum m.
Psoas n. axon function
sensory
postganglionic sympathetic
& motor innervation of the psoas m.
Lateral femoral cutaneous n. L2-3 axon function
sensory
& postganglionic sympathetic innervation of the skin overlying the
lateral aspect of the thigh
Femoral n. (L2-4, Saphenous n.) axon function
sensory
& postganglionic sympathetic innervation of the skin overlying the medial aspect of the leg
Femoral n. (L2-4, Muscular branches) axon function
sensory
postganglionic sympathetic
& motor innervation of the iliacus, pectineus, sartorius, rectus femoris, vastus lateralis, vastus medialis & vastus intermedius muscles
Obturator n. (L2-4, anterior divisions) axon function
sensory
postganglionic sympathetic
& motor innervation of the gracilis, adductor brevis, adductor longus, adductor magnus & obturator externus
muscles
Nerve to piriformis (S1, S2) axon function
sensory
postganglionic sympathetic
& motor innervation of the piriformis muscle
Nerve to the quadratus femoris (L4-5, S1) axon function
sensory
postganglionic sympathetic
& motor innervation of the quadratus femoris & inferior gemellus m.
Nerve to the obturator internus (L5, S1-2) axon function
sensory
postganglionic sympathetic
& motor innervation of the obturator internus & superior gemellus m.
Perforating cutaneous (S2-3) axon function
sensory
postganglionic sympathetic innervation of the medial part of buttock
Posterior cutaneous nerve of thigh (S1-3) axon function
sensory
postganglionic sympathetic innervation of buttock and uppermost medial and posterior surfaces of thigh
Superior gluteal nerve (L4-5, S1) axon function
sensory
postganglionic sympathetic
& motor innervation of the gluteus medius, gluteus minimis & tensor fasciae latae m.
Inferior gluteal nerve (L5, S1-2) axon function
sensory
postganglionic sympathetic
& motor innervation of the gluteus maximus m.
Identify segmental innervation of the skin Red star
1st toe - L4
Identify segmental innervation of the skin Pink star
5th toe - S1
Draw LE arterial master drawing
Compare to Drawing
Draw LE venous master drawing
Compare to drawing
Draw LE lymphatic drainage
Compare to drawing
How does arterial supply to the head and neck of the femur change with age?
Children less than 10 = primary arterial supply is the obturator artery
Adults = primary supply becomes the medial circumflex femoral artery
Femoral sheath contents
Femoral a., v., canal
Where would you take a femoral pulse?
Within the femoral triangle
Motions that occur at the hip joint
Circumduction
Flexion
Extension
Abduction
Adduction
Internal rotation
External rotation
Motions that occur at the knee joint
Flexion
Extension
Lateral Rotation of the tibia
Medial Rotation of the tibia
Sacrotuberous lig. attachments
from posterior iliac spine & lateral margin of the sacrum to the ischial tuberosity
Sacrospinous lig. attachments
from the ischial spine to lateral margin of the sacrum
Fibrous joint capsule of hip attachments
from the margin of the acetabulum to the neck, intertrochanteric line & intertrochanteric crest of the femur
Iliofemoral lig. attachments
from the anterior inferior iliac spine to the intertrochanteric line of the femur
Iliofemoral lig. function
limits extension of thigh at the hip joint
Pubofemoral lig. attachments
from the iliopubic eminence and superior pubic ramus to the fibrous capsule
Pubofemoral lig. function
limits abduction of the femur
Ischiofemoral lig. attachments
from the ischium posterior to the acetabulum to the greater trochanter & iliofemoral ligament
Ischiofemoral lig. function
assists the iliofemoral lig. in limiting extension of the femur
Ligament of the head of femur (ligamentum teres) attachments
from the fovea of the femoral head to the acetabular notch
Transverse acetabular lig. attachments
interconnects the margins of the acetabular notch
Identify the ligaments closely applied to the joint capsules (thickening of joint capsules)
ACL
PCL
MCL
LCL
Sacroiliac synovial joint classification
Plane
Hip synovial joint classification
ball & socket
Tibiofemoral synovial joint classification
bi-condylar
Proximal tibiofibular synovial joint classification
plane
Identifying features of medial meniscus
C shaped
Larger
Attached to MCL
Identifying features of lateral meniscus
O shaped
Smaller
